Clinical analysis of the application of robot-assisted laparoscopic technique for the treatment of unilateral multifocal renal tumors
Chen Jianwen1, 2 , Huang Qingbo1 , Zhang Xu1 , Li Hongzhao1 ,Zhu Jie1 , Huang Shuang1 , Du Songliang1 , Peng Cheng1 , Ma Xin1
1.Department of Urology/State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital, Beijing 100853, China; 2.Force Medical Team, 92261st Troops of PLA, Haikou
Abstract：Objective: By summarizing the clinical data of robot-assisted laparoscopic technique for the treatment of unilateral multifocal renal tumors, to evaluate the safety and feasibility of this technique and improve the treatment level of this disease. Methods: Clinical data and prognostic information of 22 patients who were admitted to PLA General Hospital from November 2013 to April 2016 with the application of robot-assisted laparoscopic technique for the treatment of unilateral multifocal renal tumors were retrospectively analyzed. Results: All the 22 operations were successfully performed, and 4 cases were given radical nephrectomy because of high grade classifications. This study included 21 males and 1 female with a mean age of 50.3 years old, 11 patients with more than 2 tumor lesions, and 6 patients with the history of radical nephrectomy for the reason of renal tumor. The pre-operative creatinine was (94.83±19.73) μmoL/L, the post-operative creatinine 3 months after surgery was (146.10±54.79) μmoL/L, the warm ischemia time was (30.08±17.50) min, the estimated blood loss was (222.7±306.5) mL, the postoperative hospital stay was (6.9±2.9) days, and the postoperative fasting days were (1.9±0.8) days. Seventeen patients were undergone transperitoneal approach, 5 patients were undergone retroperitoneal approach, and 6 patients were undergone robot-assisted laparoscopic renal artery cold perfusion surgery. The pathological diagnosis confirmed that there were 21 cases of clear cell renal cell carcinoma and 1 case of papillary renal cell carcinoma, and no positive margin and lymph node metastasis was found. No recurrence or metastasis was observed during a follow-up period of 3 to 37 months. Conclusions: Robot-assisted laparoscopic technique for the treatment of unilateral multifocal renal tumors is safe and feasible, and its short-term tumor control and renal function reservation are satisfactory. However, further larger-scale researches with longer follow-up period were required.
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